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Is COVID-19 harming your patients' oral health?

According to a recent American Dental Association (ADA) survey carried out at the beginning of November, fewer people are visiting the dentist now than before the coronavirus pandemic.

While 37.7% of dental practices are open and enjoying business as usual, the in-depth study revealed that 60.9% of practices are open, but experiencing a lower patient volume than usual. The remaining 1.4% of dental practices remained completely closed to all patients or closed to all patients except those in need of emergency treatment.

Out of the practices open and accepting regular patient appointments:

  • 18.6% are treating more than 95% of their usual patient quota
  • 27.5% are treating 86-95%
  • 25% are treating 76-85%
  • 16.6% are treating 51-75%
  • 8.2% are treating 25-50%
  • 4.1% are treating less than 25%

While these November statistics might appear favorable, the percentage of patients practices are treating has been slowly dropping since mid-September. In the week beginning September 21st, 79.1% of practices were treating at least 76% of their usual patient quota. By the first week of November, this figure had dropped down to 71.1%.

What Does This Mean for Dental Hygienists?

Despite fewer people visiting the dentist than before COVID-19 or even just a few weeks ago, dental hygienists don’t need to worry about losing their jobs.

Job Security

Out of the dental practices surveyed by ADA, 90.9% are paying their staff in full and just 7.8% are partially paying their staff. The remaining 1.3% aren’t paying any staff because their practices are closed.

The percentage of dental practices fully paying staff was rapidly increasing from mid-April. But as of the week beginning September 7th, the statistic has been dropping by around 1% every two weeks. 

This translates into approximately 15 additional dental practices across the US each week not paying their staff in full. However, this doesn’t mean dental hygienists or dental assistants have been laid off. It could simply suggest a small reduction in hours to coincide with fewer patients making appointments.

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Before the coronavirus pandemic, 56% of dentists said their practice was “highly profitable” while just 39% said it was “somewhat profitable”. When asked about their practices’ current profitability:

  • 11% answered it was “highly profitable”
  • 49% claimed it was “somewhat profitable”
  • 27% said it was “breaking just about even”
  • 9% found it was “somewhat unprofitable”

These disappointing figures could explain why not all practices are paying their staff in full. The drop in income needs to be made up for somewhere and cutting staff hours is one solution.

With the Pfizer and BioNTech vaccine shortly becoming available to the public, it’s almost certain more people will soon return to the dentist and more dental staff can get back to earning their full wages.

The Way You Work

Due to the way the virus spreads and the latest ADA guidelines, the way most dental hygienists work has changed dramatically since COVID-19 and it’s not likely to return back to normal any time soon. 

The ADA survey revealed that many dental practices have changed their usual treatment methods in an effort to reduce aerosols and curb the spread of the virus. The use of hand scaling, silver diamine fluoride (SDF), glass ionomers and fluoride varnish has increased throughout many of the practices surveyed.

Despite there being various innovative pieces of equipment to help staff and patients stay safe during the pandemic, many tasks that were once done with the help of electric tools now have to be completed by hand. One example of this is electric descalers being replaced by manual descaling tools. 

Swapping modern, efficient tools for manual tools means basic procedures that were once quick and simple now take much longer. This means patients should be allocated more time for their appointments and RDHs should expect to spend extra time in uncomfortable positions, treating patients.

What Does this Mean for Patients?

It’s not just dental hygienists and assistants who have been affected by COVID-19. Patients are enduring the negative effects, too.

More Expensive Treatments

Fear and anxiety aside, one thing that could be putting patients off from visiting the dentist is the increased cost. The ADA survey revealed that out of the dental practice owners asked, 33% said their current operating costs were “a lot higher” now than before the COVID-19 pandemic. 58% said their costs were “somewhat higher now” and just 7% said they were “about the same”. 

Although there are many ethical questions surrounding the notion of increasing treatment fees to cover PPE costs, the extra expense needs to be paid somehow. It’s the responsibility of the dental practice owner to find this additional money, whether it comes out of increased treatment costs, lower staff wages or their even own pocket.

Health Risks

Postponing elective dental treatment can be very dangerous. The mouth is the window to overall health and if patients ignore their oral wellbeing, the rest of their body could suffer as a result. Endocarditis, cardiovascular disease, birth complications in pregnant women and pneumonia are just some of the medical risks which can arise from neglecting oral care.

A buildup of oral bacteria can stop the body’s immune system from functioning correctly. Without a strong immune system, patients have an increased risk of contracting many different viruses, including COVID-19. By avoiding the dentist over fears of developing the coronavirus, patients could actually be putting themselves at risk of getting it.

This is why it’s so important to explain to your patients that it’s safe to return to the dentist for all treatments and checkups.

Damaged Teeth

As people struggle through the rules, restrictions and lockdowns as a result of COVID-19, many turn to alcohol, junk food and cigarettes to get by. All three of these are incredibly damaging to teeth. High sugar levels in alcohol and junk food create a great source for harmful bacteria to feast on, damaging the enamel, while cigarettes can cause gum disease and even make teeth fall out.

The further we get into winter, the more people are going to start taking cough syrups and lozenges. While these remedies are a great way to relieve cold symptoms, they’re terrible for your teeth. Most cold medicines contain both alcohol and sugar which can increase oral health problems. 

To avoid bacteria buildup and damaged enamel, it’s important patients maintain their oral health routine at home throughout winter and keep their dental appointments.

Tooth Loss

Periodontal gum disease isn’t the only way patients can lose their teeth during the pandemic. Everyone is feeling the stress of the current situation and high levels of anxiety cause some people to grind their teeth. Not only does teeth grinding hurt the jawbone, but it can also break or loosen teeth, causing them to fall out. 

If patients can’t ease their stress through relaxation techniques, a trip to the dentist is a helpful alternative. A dental professional will be able to design and create a protective mouth guard to keep the patient’s teeth safe while they sleep.

Keep Calm and Carry On

From changing the way dental hygienists work and lengthening appointment times to putting patients’ overall health at risk and increasing the chance of tooth loss, the COVID-19 pandemic has affected dental staff and patients in many ways beyond the obvious. As the vaccine gets distributed throughout the US, things will slowly improve for everyone. But until then, it’s important for dental staff to march forward and for patients to do all they can to maintain their oral health.

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